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<br /> <br />Community Advisory Committee Quarterly/Annual Visitation Report <br />County: Orange Facility Type: <br /> <br />Family Care Home X Nursing Home <br />Adult Care Home Combination Home <br />Facility Name/Address: <br /> <br />Carol Woods Skilled Nursing/ Carol Woods Health Center <br />750 Weaver Dairy Rd. <br />Chapel Hill, 27514 <br />Visit Date: 08/30 / 2019 Time spent in facility: 1 hr 10 min Arrival time: 9:27 X am pm <br />Name of person exit interview was held with: Melanie Johnson (Nursing) Interview was held: X in Person Phone <br />X Admin: Gavin Locklear SIC (Supervisor in Charge) Other Staff Rep. (Name & Title) <br />Committee Members Present: Bill Morgan and Jackie Podger <br /> <br /> Report Completed by: Jackie Podger <br />Number of Residents who received personal visits from committee members: 5 <br />Resident Rights Information is clearly visible: X Yes No Ombudsman Contact Info is correct and clearly posted: X Yes No <br />The most recent survey was readily accessible: X Yes No <br />(Required for Nursing Homes Only) <br />Staffing information clearly posted: X Yes No <br /> Resident Profile Yes/No/NA Comments/Other Observations <br />1. Do the residents appear neat, clean and odor free? YES <br />2. Did residents say they receive assistance with personal care <br />activities? Ex. brushing their teeth, combing their hair, inserting <br />dentures or cleaning their eyeglasses? <br />YES <br /> <br />3. Did you see or hear residents being encouraged to participate in <br />their care by staff members? N/A <br />4. Were residents interacting with staff, other residents & visitors? YES <br />5. Did staff respond to or interact with residents who had difficulty <br />communicating or making their needs known verbally? YES <br />6. Did you observe restraints in use? NO <br />7. If so, did you ask staff about the facility’s restraint policies? N/A <br />Resident Living Accommodations Yes/No/NA Comments/Other Observations <br />8. Did residents describe their living environment as homelike? YES <br />9. Did you notice unpleasant odors in commonly used areas? NO <br />10. Did you see items that could cause harm or be hazardous? YES <br />11. Did residents feel their living areas were too noisy? See Note Complaint was made by one of the residents <br />regarding another resident’s very loud verbal <br />demands and discomforts. The complaining <br />resident was moved to the other side of the <br />facility. <br />12. Does the facility accommodate smokers? <br />Where? X Outside only Inside only Both Inside/Outside <br />YES By regulation outside only.